DE102012218147A1 - ASSEMBLY COMPRISING A PIPE HOSE AND AN ENDOSCOPE PIPE - Google Patents

Abstract

The invention relates to an assembly made up of an inverted tube (1) and an endoscope tube (2), in which the inverted tube (1) surrounds a section of the endoscope tube (2). The everting tube (1) forms a tube section (1a) facing the endoscope tube (2) and a tube section (1b) pointing away from the endoscope tube (2). The tube section (1a) of the everting tube (1) facing the endoscope tube is in surface contact with the outer surface (2a) of the endoscope tube (2).

Description

The present invention relates to an assembly of an everting tube and an endoscope tube.

DESCRIPTION OF THE PRIOR ART

For visual inspection of channel-like cavities, such as e.g. The esophagus, stomach, intestine, urethra and bladder are known to use endoscopes. For this purpose, the endoscope at its distal end with a lighting device and with an optic such. a camera chip, which is connected via lines within an endoscope shaft with a camera control at the end of the endoscope shaft. The camera control is in turn connected via a video processor to an external monitor on which the attending physician can recognize the areas to be examined. The inserted into the cavity distal end of the shaft is designed to be bent in any direction.

In general, the endoscope has an elongated tubular shape with a diameter of about 9 to 15 mm and is made of a flexible material in order to be able to follow curvatures of the cavity to be examined, for example intestinal convolutions.

This increasing inward movement of the endoscope into the channel-like cavity is relatively cumbersome. The advancement of the endoscope is particularly difficult if the channel-like cavity to be inspected has narrower bends, bottlenecks or the like, as described, for example, in US Pat. in the colon of the colon is the case. If the channel-like cavity has a non-smooth wall of a low-strength material, there is a risk that the distal end will stick to the cavity wall when advancing; This can lead to damage to the cavity wall. Since the cavity has a plurality of bends, the pushing from the rear end of the endoscope exerts considerable pressure from the inside against the respective outer wall areas which are in the direction of bending. The further advancement of the endoscope is difficult.

In the prior art, therefore, a everting tube arranged around the endoscope shaft is used. This everting tube protects the interior of the cavity, e.g. the bulges of the colon wall.

What is known is an everting tube system in which an endoscope is surrounded by a tube that has been inverted, the tube having on the outside a sleeve into which a drive system can engage. The gap can be filled with lubricant between the shaft and the inner hose part. This is done through an opening that must be in a system somewhere on the endoscope shaft. Furthermore, lubricant can be pressed via the drive between the two hose parts. The two lubrication systems and the drive allow propulsion of the inner tube part at a speed twice that of moving the shaft forward. Thus, the camber is as fast progress as the shaft ends of the endoscope.

The everting tube is connected to a drive device. The drive device is in turn connected to a lubricant supply source so that lubricant between the inner tube portion and the endoscope shaft can be introduced.

Such prior art is eg in the EP 0 632 706 B1 or EP 0 873 761 A1 shown.

TASK TO BE SOLVED BY THE INVENTION

Object of the present invention is to provide an improved assembly of an everting tube and an endoscope tube.

In particular, it is the object of the present invention, the assembly of a everting tube and an endoscope tube in such a way that its functionality and handling is improved.

SOLUTION OF THE TASK

This object is achieved by an assembly of an everting tube and an endoscope tube with the features of claim 1. Advantageous developments are the subject of the dependent claims.

The invention thus relates to an assembly of an everting tube and an endoscope tube, wherein the everting tube surrounds a portion of the endoscope tube. The everting tube has a tube section facing the endoscope tube and a tube section pointing away from the endoscope tube. The tube section of the everting tube facing the endoscope tube is in surface contact with the outer surface of the endoscope tube.

The tube section of the everting tube facing the endoscope tube is seated on the endoscope tube in such a way that no relative movement is possible by displacement between them. A movement of the tube portion of the everting tube relative to the endoscope tube is only possible by the tube section of the everting tube rolls on the endoscope tube. The ratio of inner diameter of the everting tube and the outer diameter of the endoscope tube is thus such that the everting tube and endoscope tube are not relatively movable due to the static friction. Thus, there is no gap between the tube section of the everting tube pointing towards the endoscope tube and the endoscope wall. Therefore, there is also no lubricant between the tube section of the everting tube pointing toward the endoscope tube and the endoscope outer wall. Since a lubricant application is not provided on the endoscope wall, the risk of lubricant spreading in the cavity, such as the intestine and at the surgical site, is low.

The everting tube has a retaining ring in a region of the tube section, wherein the longitudinal ends of the tube section are connected to the retaining ring. As a result, the everting tube can be moved on the endoscope tube by grasping and pushing the retaining ring. As a result, the retaining ring protects the sensitive area of the everting tube, at which the longitudinal ends of the tube section are connected to the retaining ring. The two longitudinal ends of the everting tube can be joined together by a plug connection, clamping connection, welding, gluing, crimping. Other joining techniques are conceivable.

In the everting tube, lubricant can be accommodated between the tube section facing the endoscope tube and the tube section pointing away from the endoscope tube. The tube section facing the endoscope tube and the tube section pointing away from the endoscope tube together with an inner surface of the retaining ring form a closed interior of the everting tube. Since the everting tube is thus self-contained, a lubricant accommodated in its closed interior provides excellent protection against leakage of lubricant. In addition, there is no lubricant between endoscope shaft and hose, which is why the leakage protection is even more improved. This avoids the problem that the optic can be soiled by lubricant. In addition, a contamination of the patient with lubricant is better preventable. In other words, the everting tube has a closed or at least closable interior, which is surrounded exclusively by the everting tube wall and the inner surface of the retaining ring. The self-contained everting tube can be used on different types of endoscopes. Since the everting tube has a closed interior space and could contain air or a suitable gas, in special cases filling with lubricant would not even be required in order to perform the function as an endoscope insertion aid. In addition, a self-contained everting tube can be easily adapted to any standard endoscope. Thus, there is a diversity and flexibility in the application of the invention.

The everting tube can be made of silicone or a thermoplastic. The cost of the everting tube can be further reduced by the use of cost-effective materials and the material-based enabling simple production processes.

The everting tube may have a closable opening for filling lubricant. The closable opening may be provided in the retaining ring, but may also be provided separately from the retaining ring on the everting tube. As a result, a refilling or replacement of the lubricant can take place without the advantage of the closed everting tube interior being abandoned. The lubricant may be a liquid, a fluid, etc.

The closable opening can be closed by a valve, a screw cap, a plug or adhesive. Other sealing techniques are conceivable. By closable opening lubricant can be filled in the appropriate amount in the tube interior, and the hose interior can be sealed sufficiently tight.

A retaining ring can sit on a region of the hose section on which the closable opening is arranged. The retaining ring thereby protects the closable opening. The closable opening may be in the retaining ring e.g. be designed as a radial through hole. The closable opening need not even be closed by a valve, a screw cap, a plug or adhesive etc. When the retaining ring is seated sufficiently close to the area of the hose section on which the closable opening is arranged, the retaining ring can serve as the sole closure of the closable opening. If a valve, a screw cap, a plug or adhesive, etc. is used as a closure of the closable opening, the retaining ring serves as additional protection for a secure closure of the closable opening.

The retaining ring may have a through opening which forms the closable opening of the everting tube. The passage opening of the retaining ring can be provided in the radial direction. The passage opening of the retaining ring allows a suitable filling of lubricant in the everting tube via the closable opening. At the same time protects the passage opening of the Retaining rings against the ingress of foreign substances or against mechanical stress.

The hose section facing away from the endoscope tube may have a bellows-like section. When using e.g. In a colon examination, the bellows-like portion is then arranged on the outwardly facing side of the everting tube. That the opposite side of the everting tube from the bellows portion is that part of the everting tube which is first inserted into the cavity. The bellows-like portion of the tube section facing away from the endoscope tube allows the rear outwardly pointing tube part to be pulled back a little. Thereafter, the hand of the introducer engages tighter and pushes the inner tube with the shaft forward into the cavity. This is particularly advantageous when most of the everting tube is already inserted and the not yet introduced part of the everting tube offers less "gripping surface".

The assembly may also be provided with drive means having a drive force acting on the outside of the endoscope tube facing tube portion. This facilitates the insertion process and even automates it. In addition, the not yet introduced part of the everting tube can be introduced particularly advantageous, since by means of a suitable drive means the Einführschiebkraft can be applied more favorably on the tube section than by bare hand.

The drive means may be constructed such that the drive force means of the drive means is a drive wheel which engages the outside of the tube section facing the endoscope tube.

Alternatively, the drive means may be constructed such that the drive force means comprises at least two drive wheels which engage at staggered positions on the circumference of the endoscope tube on the outside of the tube section facing the endoscope tube. Since driving forces acting on staggered positions on the circumference of the endoscope tube bring about a force action of a plurality of positions, such a drive device enables a secure and uniform introduction of endoscope tube and everting tube.

The drive wheel or the drive wheels can be driven by servomotor (s) with an electronic control and a sensor system. As a rule size could serve the position of the slip edge of the hose.

The drive wheel or the drive wheels of the drive device can be accommodated in the retaining ring. The retaining ring then forms a housing for the entire drive device or at least for the drive wheel or the drive wheels. Since the retaining ring surrounds the everting tube and the endoscope tube and has a predetermined internal volume, if it is designed as a hollow body, this internal volume can be used advantageously for accommodating the drive wheels and even the motors. Multiple drive wheels and motors can be made smaller with similar performance than a corresponding drive wheel and a corresponding motor. Therefore, when using multiple drive wheels and motors, the retainer ring and the entire assembly can be made smaller.

• 1. Ein Rohr mit einem Schlauch wird so auf den Schaft geschoben, dass der Haltering am distalen Ende zu liegen kommt.
• 2. Das Rohr schaut einige Zentimeter unter der distalen Stülpkante heraus. Das Rohr wird an dieser Stelle gegriffen und der Stülpschlauch wird in der Richtung zum proximalen Ende vom Rohr geschoben.
• 3. Das Rohr wird vom Schaft gezogen.
• 4. Der Stülpschlauch wird nun wieder in der Richtung zum distalen Ende geschoben und ist dann einsatzbereit für die Untersuchung.
• 5. Das Abnehmen des Schlauchs geschieht in umgekehrter Reihenfolge.

The assembly may have a delivery cylinder on which the everting tube can be arranged and from which the everting tube is slidable onto the endoscope tube. A delivery cylinder with everting tube arranged thereon is an advantageous delivery means. A distribution with appropriate sterilizable packaging is made possible. Since he is already sitting on the delivery cylinder, the everting tube is already ready to be pushed onto the endoscope tube. This saves valuable time and simplifies handling. On a delivery cylinder can even be arranged 2 everting tubes with suitable respective sterilization. Such a delivery cylinder offers for all versions of the hose with the exception of the hose without seam a very advantageous way to bring the hose on the shaft. This can be done as follows:

• 1. A tube with a tube is pushed onto the shaft so that the retaining ring comes to lie at the distal end.
• 2. The tube looks out a few inches below the distal curb. The tube is gripped at this point and the everting tube is pushed in the direction towards the proximal end of the tube.
• 3. The tube is pulled from the shaft.
• 4. The everting tube is now pushed back in the direction of the distal end and is then ready for use.
• 5. The removal of the hose is done in reverse order.

The above-explained aspects of the present invention can be suitably combined.

Hereinafter, the present invention will be described in more detail with reference to accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

1 shows a first embodiment of the present invention in a schematic cutaway perspective view.

2 shows a second embodiment of the present invention in a schematic cutaway perspective view.

3 shows a third embodiment of the present invention in a schematic cutaway perspective view.

4 shows a fourth embodiment of the present invention in a schematic double-cut perspective view.

EMBODIMENTS

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings.

First embodiment

1 A first embodiment of the present invention in a schematic cutaway perspective view.

More specifically shows 1 a first embodiment of an assembly of an everting tube 1 and an endoscope.

The endoscope has an endoscope tube 2 on. The everting tube 1 is on the endoscope tube 2 arranged. Here is the everting tube 1 on the endoscope tube 2 arranged so that it leads to the endoscope tube 2 pointing hose section 1a and one from the endoscope tube 2 pointing away hose section 1b Has. At both longitudinal ends of the everting tube 1 is the everting tube 1 everted and forms in each case an inverted end. The everting tube 1 thus has two eversion ends, as shown in the drawing. The respective everting end of the everting tube 1 forms the transition between the endoscope tube 2 pointing hose section 1a and that of the endoscope tube 2 pointing away hose section 1b , In other words, the everting tube 1 closed in itself and forms an interior, which is between the endoscope tube 2 pointing hose section 1a and that of the endoscope tube 2 pointing away hose section 1b located. More specifically, the interior is between the endoscope tube 2 pointing hose section 1a , a front everting end 1c from the endoscope tube 2 pointing away hose section 1b and a rear everting end 1d Are defined.

The interior of the everting tube 1 is completely in the present embodiment of the wall of the everting tube 1 surround. The interior of the everting tube 1 can be filled with a lubricant or alternatively remain unfilled in rare special cases.

The tube section facing the endoscope tube 1a the everting tube 1 is in surface contact with the outer surface of the wall 2a of the endoscope tube 2 , This surface contact with the outer surface of the wall 2a of the endoscope tube 2 can extend over the entire tube section facing the endoscope tube 1a the everting tube 1 extend. In this case, the hose section facing the endoscope tube is located 1a the everting tube 1 between the front everting end 1c and the rear everting end 1d in surface contact with the outer surface of the wall 2a of the endoscope tube 2 , The tube section facing the endoscope tube 1a the everting tube 1 is doing so on the endoscope tube 2 curious that no relative movement by moving between them is possible. A movement of the hose section 1a the everting tube 1 relative to the endoscope tube 2 takes place only by the hose section 1a the everting tube 1 on the endoscope tube 2 rolls.

The everting tube 1 is made of silicone or a thermoplastic. He can on both sides z. B. be coated with polytetrafluoroethylene.

The everting tube 1 can be made in different ways. In one way of making a hose body is produced, which is cut into everting tube blanks of suitable lengths. The everting tube blanks are everted and merged at its longitudinal ends so that the longitudinal ends face each other. Then the two longitudinal ends of the everting tube 1 for example, by means of clamping, welding, gluing or crimping, each with one side of a retaining ring 3 connected, as in 1 is shown.

The retaining ring 3 has a hollow cylindrical shape. The retaining ring 3 is a ring body, which is formed of an outer body and an inner body. The outer body consists of two in cross-section L-shaped ring elements, wherein the two L-shaped ring elements sandwich the inner body seen in the longitudinal direction of the endoscope.

The retaining ring 3 has in this example such an inner body extending in the radial direction to the endoscope tube 2 extends and is provided on its inner peripheral side with a flange portion such that the inner body of the retaining ring 3 in sectional view forms a T-shape, in which the horizontal bars of the T to the endoscope tube 2 points. At the endoscope longitudinal ends facing out surfaces of the inner body, ie, on the front and the back, in each case a ring member of the outer body is arranged so that the leg of the L-shape at the endoscope tube 2 facing side and away from the inner body of the retaining ring 3 extends away. The from the endoscope tube 2 away facing outer peripheral surface of the two ring elements is aligned with the located between them outer peripheral surface of the inner body.

The two extending to the front / back leg of the L-shape of the ring elements form at their endoscope tube 2 inner circumferential surface having an outer holding surface for holding a respective end portion of the longitudinal end of the hose section 1b , The from the endoscope tube 2 pointing away outer peripheral surfaces of the two flange portions on the horizontal bar of the T of the inner body of the retaining ring 3 to the endoscope tube 2 facing inner circumferential surfaces of the ring members, forming an inner holding surface for holding a respective end portion of the longitudinal end of the hose portion 1b , Between the inner retaining surface and the outer retaining surface is in each case an end portion of the longitudinal end of the hose section 1b firmly inserted, wherein preferably the respective end face of the end portion of the longitudinal end of the hose section 1b on the vertical bar of the T-shaped inner body of the retaining ring 3 is applied. Thus, the respective end portion of the longitudinal end of the hose portion 1b from three sides, that is surrounded by the inner support surface of the inner body, a vertical portion of the inner body and the outer holding surface of the legs of the ring elements, and for example by gluing process firmly connected to them.

The everting tube 1 may, for example, have the following size: A colonoscope as an endoscope may have a length of about 1.4 m and a diameter of about 1 cm. Accordingly, a tube could have a length of 0.7 m, a wall thickness of approx. 1 mm and an inner diameter of approx. 1 cm in the inverted state.

However, the endoscope dimensions may vary in diameter and length depending on the application, and the present invention is not limited to the dimensions indicated.

In the first embodiment, the everting tube 1 with the retaining ring 3 provided so that the retaining ring 3 Centric in its inner body a radially extending lockable access opening 4 as a through hole to the interior of the everting tube 1 having. In an alternative, not shown in the drawings, the everting tube 1 without access opening 4 , So be executed completely closed and may contain a lubricant in its interior, which is a favorable rolling of the everting tube 1 on the endoscope tube 2 , If such a lubricant is used, due to the lubricant therebetween, the one to the endoscope tube 2 pointing hose section 1a and the endoscope tube 2 pointing away hose section 1b spaced and the tube sections 1a and 1b do not rub directly against each other. The lubricant is in an appropriate amount in the production of the everting tube 1 filled.

In this embodiment, the retaining ring 3 in the endoscope tube 2 pointing away hose section 1b of the everting tube 1 integrated as described above. The retaining ring 3 consists of a suitable material such as silicone or thermoplastic.

The retaining ring 3 can the everting tube 1 on the endoscope tube 2 let it roll better by the user's hand a Umgreifbewegung in the direction of insertion immediately behind the retaining ring 3 located part of the hose section 1b in contact with the retaining ring 3 grasps. The on the everting tube 1 applied force can then both from the hose section 1b as well as the retaining ring 3 be recorded.

The lockable opening 4 is designed so that it is a small tube-like portion radially in the retaining ring 3 in the endoscope tube 2 extending away direction. The small tubular portion of the closable opening 4 facilitates the filling of lubricant into the interior of the everting tube 1 ,

In the presentation of 1 is the closable opening 4 through a plug 5 closed, in the closable opening 4 has been pushed in. Here is the closable opening 4 an inner diameter slightly smaller than the outer diameter of the plug 5 is to get a sufficient tight fit of the plug 5 to ensure. In the second embodiment, the closing of the closable opening 4 not on the stopper 5 limited. The lockable opening 4 can be closed by a valve, a screw cap, or by adhesive. In the closed state of the closable opening 4 is then the interior of the everting tube 1 also completely closed.

The lockable opening 4 may have a diameter of 1 mm, but the present invention is not limited to this extent.

The following is the application of the everting tube 1 on the endoscope tube 2 explained.

In the present embodiment, the forward movement of the everting tube takes place 1 along the endoscope tube 2 manually, adding the everting tube 1 on the endoscope tube 2 is rolled off. With one hand the endoscope tube becomes 2 pushed into the cavity to be examined and with the other hand is the everting tube 1 by attacking and pushing on the retaining ring 3 on the endoscope tube 2 unrolled. When moving in the endoscope tube 2 The everting tube pushes into the intestine 1 on the endoscope tube 2 forward, when the endoscope tube 2 pointing away hose section 1b is held manually. The everting tube moves 1 on the endoscope tube 2 half the length forward to the endoscope tube 2 itself is moved forward. The tube is held at the proximal end of one hand and the shaft with the other hand, so to speak pushed into the everting tube. This avoids that the entire device buckles when inserted.

For the forward movement of the everting tube 1 The present embodiment is done manually and no drive device is required.

Second embodiment

2 shows a second embodiment of the present invention in a schematic cutaway perspective view.

In this embodiment, the hose section facing away from the endoscope tube has 1b an area with a bellows-like section 1e , The bellows-like section 1e of the hose section 1b is with the retaining ring 3 combinable, as in 2 is shown. In the present embodiment, the bellows-like section 1e either to the retaining ring 3 adjacent or close to the retaining ring 3 arranged. More specifically, the bellows-like section 1e on the side of the retaining ring 3 arranged, which is opposite during insertion of the endoscope to the insertion side - ie to the cavity to be examined.

The bellows-like section 1e forms a part of the hose section 1b and is in a length in the longitudinal direction of the endoscope tube 1 formed, which corresponds approximately to the width of a human hand. Despite the bellows-like section 1e the everting tube forms a closed interior, that of the endoscope tube 2 pointing hose section 1a , the front inverted end 1c from the endoscope tube 2 pointing away hose section 1b , the rear everting end 1d and the bellows-like section 1e and the retaining ring 3 is surrounded.

When used in, for example, a colon examination, the pelvic section is 1e thus on the outwardly facing side of the everting tube 1 arranged.

The bellows-like section 1e of the endoscope tube 2 pointing away hose section 1b allows you to pull the rear outward-pointing hose part a bit to the rear. Thereafter, the hand of the introducer engages tighter and pushes the inner tube with the shaft forward into the cavity. This is particularly advantageous if already the largest part of the everting tube 1 introduced and the not yet introduced part of the everting tube 1 offers less grip surface.

Third embodiment

3 shows a third embodiment of the present invention in a schematic cutaway perspective view.

In this embodiment, the assembly is one in the retaining ring 3 accommodated drive device 6 with a drive wheel 7 fitted. The drive wheel 7 engages the hose section pointing towards the endoscope tube 1a on the outside, ie at the endoscope tube 2 opposite side surface, on. The drive wheel 7 is in frictional engagement on the outside of the tube section pointing towards the endoscope tube 1a , allowing a power transmission between the drive wheel 7 and the hose section 1a is possible.

In the present embodiment, the drive device 6 a shaft on, with the shaft on its front side with the drive wheel 7 is provided. The shaft is drive connected to an electric motor or other drive source.

Preferably, the drive wheel 7 in the retaining ring 3 at a position on the hose section 1a arranged along a circumferential line of the hose section 1a offset by 180 ° to the opening 4 is.

By the present embodiment, the insertion process can be facilitated and even automated. In addition, the not yet introduced part of the everting tube can be introduced particularly advantageous, since by means of a suitable drive means the Einführschiebkraft can be applied more favorably on the tube section than by bare hand.

Fourth embodiment

4 shows a fourth embodiment of the present invention in a schematic double-cut perspective view.

In this embodiment, the assembly is with a drive device 6 with two drive wheels 7 . 8th fitted. The two drive wheels engage the endoscope tube 2 at different positions along the circumference of the hose section 1a in the retaining ring 3 are offset, on.

The drive wheel 7 forms a first drive wheel and the other drive wheel 8th forms a second drive wheel. Both drive wheels 7 and 8th are formed in this example as driven wheels. The two drive gears 7 and 8th each bring a driving force transmission to the hose section 1a on. The points of attack on the hose section 1a applied force can in the retaining ring 3 as in the example shown by about 120 ° along a circumferential line of the hose section 1a be arranged. An unillustrated third drive wheel can then turn around 120 to the two drive gears 7 and 8th along a circumferential line of the hose section 1a be arranged offset. The driving force on the hose section 1a at three by 120 ° along a circumferential line of the hose section 1a Offset positions so applied that three drive gears have a pushing force to the endoscope tube 2 towards the hose section 1a muster.

In an alternative not shown, two may also be 180 ° along a circumferential line of the tube section 1a offset arranged drive gears may be provided. Thus, the driving force on the hose section 1a applied on two opposite sides so that both drive gears a pressing force towards each other on the hose section 1a muster.

Thus, for a movement of the everting tube 1 a safe power transmission from the drive wheels to the hose section 1a guaranteed.

In the present embodiment, the drive device 6 two shafts on, with the first shaft on its front side with the first drive wheel 7 is provided and a second (not shown) shaft on its end face with the second drive wheel 8th is provided.

The two shafts may be drive-connected via suitable power transmissions to the same electric motor or other same drive source. Alternatively, each of the two shafts may be separately drive coupled to its own electric motor or other drive source.

By the present embodiment, the insertion can be facilitated and even automated, while the power transmission for the insertion process are made even safer. In addition, the not yet introduced part of the everting tube can be introduced particularly advantageous, since by means of a suitable drive means the Einführschiebkraft can be applied more favorably on the hose section than with only one drive wheel. In fact, if multiple drive wheels are used, each with its own electric motor, smaller electric motors can be used and used as a housing for the drive wheels and electric motors retaining ring 3 and thus the entire assembly can be made smaller.

Further embodiments

The assembly of everting tube 1 and endoscope tube 2 has a delivery cylinder on which the everting tube 1 can be arranged and from which the everting tube 1 on the endoscope tube 2 slidable.

The delivery cylinder with everting tube arranged thereon 1 can be sold with appropriate internally sterilizable packaging. Since he is already sitting on the delivery cylinder, the everting tube is 1 already in readiness, on the endoscope tube 2 to be pushed. This saves valuable time and simplifies handling.

In one alternative, even two or more everting tubes may be arranged on a delivery cylinder.

Effect and advantages of the present invention

The present invention of the assembly of the everting tube 1 and the endoscope tube 2 can be advantageously used in a treatment or visual examination of canal-like cavities such as the esophagus, stomach, intestine, urethra and bladder. In particular, in a treatment or visual examination of the colon of the colon, the present invention, the assembly of the everting tube 1 and the endoscope tube 2 advantageous applicable. The colon can be roughly divided into the ascending colon (ascending colon), the transverse colon (colon transversum) and the descending colon (colon descendens). During a treatment or visual examination of the colon, the endoscope is inserted via the rectum and sigma from the descending colon into the transverse colon.

Earlier systems were usually designed so that the everting tube has always covered the entire shaft length. From a medical point of view, however, the sigma in the lowest part of the colon, ie the colon descendens, is the most difficult part of colonoscopy. Here it is particularly difficult to bring the rigid coloscope around the tight curve. Various techniques are available to the experienced gastroenterologist. Depending on the anatomy of the patient, he may try to thread a piece of the intestine by hooking on the deflecting and pulling up a piece of the intestine. Through clever turning and bending of the deflecting, it is often possible to reach the narrow flexures. Occasionally, a nurse has to shine the coloscope through the abdominal wall and form a so-called hypomochlion. Relocation of the patient is also a proven method for advancing the endoscope. In many cases, however, motility-inhibiting medicines such as buscopan must be administered.

It thus represents a significant advantage to only appear on the lower part of the colon. If the endoscope has arrived in the colon transversum (half the length of the coloscope), no difficulties in advancing are expected. An everting tube 1 The present invention, which can be handled without a complicated drive device or even completely without a drive device and thereby has a particularly small dimension in the radial direction (seen from the endoscope), is ideally suited for such a treatment.

For an assembly consisting of an everting tube 1 and an endoscope tube 2 According to the present invention, when used in the intestine, for example, only the "front" part of the everting tube 1 contaminated. When sliding out the everting tube 1 becomes this "front" part of the everting tube 1 on the endoscope tube 2 unrolled and located at the endoscope tube 2 pointing page. Thus, in the present invention, there is a contaminated portion of the everting tube 1 never on the endoscope tube 2 pointing away turnout tube outside.

• • Einfach an jedes gängige Endoskop zu adaptieren.
• • Kein Schmiermittel zwischen Schaft und Schlauch, deshalb keine Leckage und keine Kontamination mit Schmiermittel
• • Innerer Schmiermittelraum ist geschlossen. Kein Befüllen mit Schmiermittel erforderlich
• • Kein Schmiermittel auf der Optik
• • Auflegen und Abnehmen des Schlauchs auf das Endoskop in weniger als einer Minute
• • Verringerung der Rigität des Endoskopschaftes möglich aber nicht zwingend erforderlich
• • Sehr genaue Positionierung des distalen Endes möglich, keine Bewegungs-Hysterese
• • Antrieb nicht unbedingt erforderlich, daher ein Antriebsarm nicht unbedingt nötig, freie Beweglichkeit des Patienten
• • Keine Überstressung des Materials durch zu hohe Schubkräfte
• • Herstellkosten liegen bei wenigen Euro
• • Die Endoskopie geht schneller, daher mehr Patientenuntersuchungen möglich.

In addition, the assembly of everting tube and endoscope tube according to the invention offers the following advantages:

• • Easy to adapt to any common endoscope.
• • No lubricant between stem and hose, therefore no leakage and no contamination with lubricant
• • Inner lubricant space is closed. No filling with lubricant required
• • No lubricant on the optics
• • Place and remove the tube on the endoscope in less than a minute
• • Reduction of the rigidity of the endoscope shaft possible but not absolutely necessary
• • Very accurate positioning of the distal end possible, no movement hysteresis
• • Drive not absolutely necessary, therefore a drive arm is not absolutely necessary, free movement of the patient
• • No overstressing of the material due to excessive shear forces
• • Manufacturing costs are a few euros
• • The endoscopy is faster, therefore more patient examinations possible.

• • Das Schlauchsystem funktioniert nur mit einem speziell für den Schlauch angefertigten Endoskopschaft. Es können nicht alle auf dem Markt befindlichen Endoskope an das Schlauchsystem angeschlossen werden, allein schon deshalb, weil die innere Schmiermittelzufuhr fehlt.
• • An den beiden Stülpenden tritt üblicherweise Schmiermittel aus, welches das Patientenumfeld kontaminiert. Betroffen ist im Besonderen die Patientenliege, der umliegende Fußboden sowie die Instrumente.
• • Das Schmiermittel, welches sich im Antrieb befindet, wird zwar vor Beendigung der Untersuchung abgesaugt aber es befindet sich noch immer so viel Schmiermittel im Antrieb, dass dieser beim Öffnen des Antriebs entweicht. Dieser Vorgang ist bei jedem Wechsel des Schlauchsystems vor jeder Untersuchung notwendig.
• • Das Befüllen des Systems mit Schmiermittel dauert ca. 5 Minuten.
• • Das Schmiermittel, welches unweigerlich auch in den Darm gelangt neigt dazu, die Oberfläche der Optik zu benetzen, was zu einer schlechteren Sicht führen kann.
• • Die Antriebseinheit muss gegen den Widerstand der inneren Reibung, welche vom Schmiermittel verursacht, wird den inneren Schlauch nach vorn treiben. Der Schaft folgt dieser Bewegung mehr oder weniger den nicht determinierten Zuständen des Schmiersystems. Dies führt dazu, dass eine exakte Positionierung des Systems nur sehr schwer möglich ist. Üblicherweise möchte der Arzt eine gewünschte Stelle im Darm genau betrachten. Dazu fährt er den Antrieb ein Stück nach vorne. Die Schubkräfte im Schlauch bauen sich langsam auf, ohne dass es vorerst zu einer Bewegung kommt. Ist der Schaft in Gang gesetzt, fährt er oft über die gewünschte Stelle hinaus, obwohl der Antrieb selbst schon nicht mehr fährt. Also muss auf dieselbe Weise zurückgefahren werden (Bewegungs-Hysterese).
• • Der Antrieb muss mit einem Haltearm am Patienten fixiert werden. Aufgrund der auftretenden Kräfte und der großen Hebellängen besteht die Gefahr, dass die Versorgungseinheit gekippt wird. Der Haltearm steht bei einer eventuell notwendigen Umlagerung des Patienten im Weg.
• • Der Schlauch benötigt eine Wandstärke von ca. einem Millimeter, um die Schubkräfte des Antriebs auszuhalten. Dies erhöht die Gesamtrigidität der Schlauch-Schaft-Kombination. Ist die Wandstärke dünner, kann es zu einer Schuppung oder Überstülpung des inneren Schlauchteils kommen. Eine solche Überstülpung führt zu einer irreversiblen Überdehnung des Silikonmaterials und die Untersuchung muss abgebrochen werden.
• • Systeme des Standes der Technik arbeiten häufig mit einem speziellen Endoskopschaft als Einwegausführung, daher sind die Herstellkosten und Anwendungskosten sehr hoch.

The following disadvantages have been encountered in previously used systems and can be overcome by the present invention:

• • The hose system only works with a specially designed tube for the endoscope. Not all endoscopes available on the market can be connected to the hose system, if only because the internal lubricant supply is missing.
• • Lubricant usually escapes from both inverters, contaminating the patient environment. In particular, the patient bed, the surrounding floor and the instruments are affected.
• • Although the lubricant in the drive is sucked off before the end of the examination, there is still so much lubricant in the drive that it escapes when the drive is opened. This procedure is necessary every time the hose system is changed before each examination.
• • It takes about 5 minutes to fill the system with lubricant.
• • The lubricant, which inevitably gets into the intestine, tends to wet the surface of the optic, which can lead to a poorer view.
• • The drive unit must be against the resistance of the internal friction caused by the lubricant, will drive the inner hose forward. The stem follows this movement more or less the non-deterministic states of the lubrication system. This means that an exact positioning of the system is very difficult. Usually the doctor wants to look closely at a desired spot in the gut. For this he drives the drive a bit forward. The thrust forces in the tube build up slowly, without it comes to a movement for the time being. If the shaft is set in motion, it often drives beyond the desired position, even though the drive itself no longer drives. So you have to go back in the same way (motion hysteresis).
• • The drive must be fixed to the patient with a support arm. Due to the forces and the large lever lengths is the Danger that the supply unit is tilted. The arm is in the event of a possible rearrangement of the patient in the way.
• • The hose requires a wall thickness of about one millimeter to withstand the thrust forces of the drive. This increases the overall rigidity of the hose-stem combination. If the wall thickness is thinner, it can lead to a scaling or protuberance of the inner tube part. Such a protuberance leads to irreversible overstretching of the silicone material and the examination must be stopped.
• "Prior art systems often work with a special endoscope shaft as a one-way design, therefore, the manufacturing and application costs are very high.

LIST OF REFERENCE NUMBERS

1

inverted sleeve

1a

 tube section facing the endoscope tube

1b

 away from the endoscope tube tube section

1c

 front everting end

1d

 rear everting

1e

 bellowed section

2

endoscope tube

2a

 Endoscope tube wall

3

retaining ring

4

lockable opening

5

Graft

6

driving means

7

(first) drive wheel on the everting tube

8th

second drive wheel on the everting tube

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• EP 0632706 B1 [0008]
• EP 0873761 A1 [0008]

Claims (14)

Assembly of an everting tube ( 1 ) and an endoscope tube ( 2 ), in which the everting tube ( 1 ) a portion of the endoscope tube ( 2 ), characterized in that the everting tube ( 1 ) to the endoscope tube ( 2 ) pointing hose section ( 1a ) and one from the endoscope tube ( 2 ) pointing away hose section ( 1b ), wherein the tube section facing the endoscope tube ( 1a ) of the everting tube ( 1 ) in surface contact with the outer surface ( 2a ) of the endoscope tube ( 2 ). Assembly of an everting tube and an endoscope tube according to claim 1, characterized in that the everting tube ( 1 ) a retaining ring ( 3 ) in an area of the hose section ( 1b ), wherein with the retaining ring ( 3 ) the longitudinal ends of the hose section ( 1b ) are connected. Assembly of an everting tube and an endoscope tube according to one of claims 1 or 2, characterized in that in the everting tube ( 1 ) between the endoscope tube ( 2 ) pointing hose section ( 1a ) and the endoscope tube ( 2 ) pointing away hose section ( 1b ) Lubricant is accommodated. Assembly of an everting tube and an endoscope tube according to one of claims 1 to 3, characterized in that the everting tube ( 1 ) consists of silicone or a thermoplastic. Assembly of an everting tube and an endoscope tube according to one of claims 1 to 4, characterized in that the everting tube ( 1 ) has a closable opening for filling lubricant. Assembly of an everting tube and an endoscope tube according to claim 5, characterized in that the closable opening is closable by a valve, a screw cap, a plug or adhesive. Assembly of an everting tube and an endoscope tube according to one of claims 2 to 6, characterized in that the retaining ring ( 3 ) at an area of the tube section ( 1b ) is seated, on which the closable opening is arranged. An assembly comprising an everting tube and an endoscope tube according to one of the claims 7, characterized in that the retaining ring ( 3 ) has a through opening which the closable opening of the everting tube ( 1 ). Assembly of an everting tube and an endoscope tube according to one of claims 1 to 8, characterized in that the endoscope tube ( 2 ) pointing away hose section ( 1b ) has a bellows-like portion. An assembly comprising an everting tube and an endoscope tube according to one of claims 1 to 9, with a drive device ( 6 ) with a driving force means on the outside of the endoscope tube ( 2 ) pointing hose section ( 1a ) attacks. An assembly comprising an everting tube and an endoscope tube according to one of the claims 10, characterized in that the driving force means of the drive device ( 6 ) is a drive wheel, which on the outside of the endoscope tube ( 2 ) pointing hose section ( 1a ) attacks. An assembly comprising an everting tube and an endoscope tube according to one of the claims 10, characterized in that the driving force means of the drive device ( 6 ) comprises at least two drive wheels, which at staggered positions on the circumference of the endoscope tube ( 2 ) on the outside of the endoscope tube ( 2 ) pointing hose section ( 1a attack). Assembly of an everting tube and an endoscope tube according to one of the claims 11 or 12, characterized in that the drive wheel or the drive wheels of the drive device in the retaining ring ( 3 ) is / are housed. Assembly of an everting tube and an endoscope tube according to one of claims 1 to 13, characterized in that the assembly comprises: a delivery cylinder on which the everting tube ( 1 ) can be arranged and from which from the everting tube ( 1 ) on the endoscope tube ( 2 ) is slidable.

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